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Melasma: Causes, Dignosis and Treatments

What is Melasma?

Melasma is a depigmentation skin condition manifested by patches or spots. This pigmentary disorders happens due to the overproduction of melanin cells responsible for your skin’s color.

Even though melasma is not an inherited disorder, there is a genetic predisposition to darker skin color. Another predisposing factor is UV light. Hormonal factors play a pivotal role in melasma, such as pregnancy or being on birth control pills. 

Is Melasma common?

Melasma affects people of any race, however it is more common in darker skin types. This skin conduction also affects more women than men, about nine times more, especially during pregnancy or  birth control treatments. Indeed, Melasma is present in 15% to 50% of pregnant patients. This condition can be explained by elevated levels of hormones in the body.

Where it can appear?

Usually, Melasma appears on the cheeks, upper lips, nose bridge, chin, and forehead. It also can emerge on other body parts like arms, back, and neck.

How to diagnose melasma?

Melasma is usually diagnosed by your provider after a visual examination of the affected area. However, a Wood lamp examination or biopsy of the area can be performed for a more accurate diagnosis.

What triggers this pigmentary disorders ?

UV light exposure, hormonal influence such as pregnancy, or being on birth control medication.

What are the different types of Melasma?

There are three types of melasma based on the involved layer of the skin:

  • Epidermal Melasma: This type is located on the most superficial layer of skin. It appears as a dark brown color or well-defined border, visible under black light.  In most cases, responds well to treatment.
  • Dermal Melasma: This type is located on the deeper layer of skin. It has a light brown or bluish color, and a blurry border that appears no differently under black light. This type does not react to treatment.
  • Mixed Melasma: This type is the most common of all three. It has both bluish and brown patches. Usually shows a mixed pattern under blacklight and a mild response to treatment.

What are the best treatments for melasma?

The most common treatment would be the appliance of a topical cream provided by a professional and the avoidance of sun exposure. In addition to that, it has been proved that some medical aesthetics treatment has been very efficient and produce results faster than topical medications. The treatment options include depigmentation topical chemical peel ( Cosmelan peel ), non-ablative laser, RF microlending, and photoprotection. Based on the type of melasma, your provider may recommend any of these treatments or a combination.


Before and after Picture of Melasma treatment

Prevention of Melasma

Photoprotection is the most effective way to prevent melasma or the progression of melasma. Broad spectrum UVA/UVB sunscreen with Iron oxide has more broad protection against visible light. The usage of ‘makeup, wearing protective clothing, and wearing a wide-brimmed hat.

Can I use makeup to cover my melasma?

Of course, wearing Broad spectrum UVA/UVB sunscreen first, followed by makeup, will provide more protection on the skin.

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